Virginia Garcia Provides Access to Health Care During Hard Times
The passage of the health care reform legislation marks a turning point in access to health care in America. Though not a panacea for all of the problems, this legislation means that most Americans will soon be able to get the care they need, many for the first time.
In the short run it means that instead of trips to the emergency room, patients will be able to access care in a clinical setting. In the long run, it could mean 
a health care model in which patients have a medical home for their health care needs. For Virginia Garcia Memorial Health Center, providing a medical home is business as usual.
(Pictured at left, Virginia Garcia patient Rosie and her baby.)
The recession that began more than two years ago has been more severe than any economic downturn since the Great Depression. Like the rising demand for food stamps and welfare benefits, the increase in people turning to safety net clinics reflects the millions of Americans who have lost their jobs and are asking for basic help.
“Even before the economic downturn we had about 95,000 Oregonians in our service area without health insurance” said Gil Muñoz, CEO of Virginia Garcia Memorial Health Center. “That’s about 16% of our population uninsured and that’s before the unemployment rate in Oregon doubled. We are taking on new patients regularly, but it pales in comparison to the demand.”
For many people, lack of health insurance often means they do not seek treatment for serious and/or deteriorating health conditions. Take diabetes.
(Pictured at right, Virginia Garcia patients)
Recently a patient was referred to Virginia Garcia after having been to the Emergency Department complaining of extreme fatigue and blurred vision. He was tested and found to be diabetic; treated and discharged with medications and dietary instructions to control his condition. But he had lost his job and had no health insurance. And because the medications for diabetes are very expensive, he did not fill his prescriptions. By the time he was seen at Virginia Garcia, his health had deteriorated even further, causing him to need extensive and costly treatment.
“Our system is backwards,” according to Muñoz. “We need to get to people before they spiral out of control.”
Which is exactly what Virginia Garcia strives to do with its medical home model; to give each patient a place to come for ongoing medical care. Once a patient is seen at a Virginia Garcia clinic, they are assigned to a primary care physician as part of a team of providers. The team monitors each patient’s health on an ongoing basis, including health education and disease prevention as part of their overall health care plan. It’s the continuity of care that distinguishes Virginia Garcia from an urgent care clinic.
“We don’t have a waiting list and we open medical home slots as often as we have providers available,” said Muñoz. “We try to strike a balance between providing comprehensive care and access to those who come knocking at our door. Unfortunately, we’re missing people.”
(Pictured at left, Virginia Garcia patients.)
The federal government has provided some relief to safety net providers through stimulus legislation. Last year, Virginia Garcia received federal stimulus dollars that allowed for increased patient capacity. In 2009, Virginia Garcia added 10 new providers between the six clinics, which will mean adding about 7,000 patients over a two year period. Part of that money has allowed for the expansion of the Virginia Garcia dental clinic, adding two new providers and an outreach specialist with a focus on patients with diabetes who often have extensive dental care needs.
“Some of the patients’ dental needs are beyond our scope,” said Muñoz, “dentures for example. We have to work with specialists to try to leverage services for our patients who cannot pay the out of pockets costs. We have an excellent relationship with ODS dental labs who have been our partners in providing some of the dental work our patients need.”
Virginia Garcia clinics are seeing more kids with the expansion of the Oregon Health Plan's Healthy Kids Program. Both the Tigard and Forest Grove School Based Health Centers are engaged in outreach to families who qualify for the expanded OHP coverage. Federal expansion grant money has also allowed Virginia Garcia to add behavioral health specialists in the clinics. At VG Beaverton, a full time psychologist divides his time between the teams to assist in overcoming patients’ barriers to successful treatment. In response to increased demand, VG Hillsboro will soon offer extended evening hours and the other clinics plan to follow suit.
Health care in America is at a crossroads and many agree that the current system is on an unsustainable trajectory. Even those who have health insurance may be faced with higher co-pays and deductibles in the future. As the debate on health care continues in Congress, so does the work of the safety net clinics around the country.
(Pictured above, Virginia Garcia patient, Kim and her mother, Joann.)
“For us this debate is not an academic exercise,” said Muñoz. “It plays out in our clinics on a daily basis. Its people’s lives. We’re trying to respond to a very large need for health care in Oregon. We know what needs to be done and we’re doing it for more than 30,000 Oregonians each year.”
